Department of Radiation Oncology, Fudan University Shanghai Cancer Center , Shanghai , China.
Department of Oncology, Shanghai Medical College, Fudan University , Shanghai , China.
Cancer Invest. 2019;37(8):387-392. doi: 10.1080/07357907.2019.1656731. Epub 2019 Sep 2.
Desmoid tumors are locally aggressive nonmalignant soft tissue tumors, which frequently recur after therapy. The optimal treatment is still controversial because of the lack of large research. A few studies have reported the effects of other treatments in one lesion when surgery is not possible or would cause notable functional impairment. Our aim was to examine the outcome of radiotherapy (RT) in the treatment of primary or recurrent unresectable desmoid tumors of the neck. A retrospective analysis was performed on 30 patients between 1/2008 and 12/2017, with 3 primary and 27 recurrent unresectable desmoid tumors of the neck. All cases were reviewed by pathologists. The median follow-up time was 50.5 months (range 2-126 months). Radiotherapy doses varied from 50 to 66 Gy (median 60 Gy, 23/30 patients) with all fraction size of 2 Gy. The objective response rate (ORR: CR or PR) to definitive RT was 56.7% (17/30 patients). On Chi-square statistic, ORR was significantly influenced by tumor size (≤5 cm versus >5 cm) ( = .046). Age (≤ 40 versus >40 years) ( = .804), gender ( = .629), and RT dose (≤60 versus >60 Gy) ( = .613) were not significantly associated with ORR. The most common acute side effects of the radiation-related complication were grade 1-2 skin toxicities. Radiotherapy is a valuable option in the management of primary or recurrent unresectable DTs of the neck with good local control. Multi-institutional and prospective studies are warranted to further validate our findings.
硬纤维瘤是局部侵袭性的非恶性软组织肿瘤,治疗后常复发。由于缺乏大型研究,最佳治疗方法仍存在争议。一些研究报告了在手术不可行或会导致明显功能障碍的情况下,其他治疗方法在一个病变部位的效果。我们的目的是研究放疗(RT)在治疗原发性或复发性不可切除的颈部纤维瘤中的作用。对 2008 年 1 月至 2017 年 12 月期间的 30 例患者进行了回顾性分析,其中 3 例为原发性,27 例为复发性不可切除的颈部纤维瘤。所有病例均由病理学家进行复查。中位随访时间为 50.5 个月(范围 2-126 个月)。放疗剂量从 50 到 66Gy 不等(中位剂量 60Gy,23/30 例患者),所有分割剂量均为 2Gy。确定性 RT 的客观缓解率(ORR:完全缓解或部分缓解)为 56.7%(30 例患者中的 17 例)。在卡方检验中,ORR 与肿瘤大小(≤5cm 与>5cm)显著相关( = .046)。年龄(≤40 岁与>40 岁)( = .804)、性别( = .629)和 RT 剂量(≤60 与>60Gy)( = .613)与 ORR 无显著相关性。最常见的急性放射相关并发症是 1-2 级皮肤毒性。放疗是治疗颈部原发性或复发性不可切除 DTs 的一种有价值的选择,具有良好的局部控制效果。需要进行多机构和前瞻性研究,以进一步验证我们的发现。